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Epoch health expanding in Arkansas.

Although Epoch Health touts that it can treat symptoms related to low testosterone in men, it maintains it's nothing like the low-T retail outlets that are gaining scrutiny from some members of the medical community.

Epoch Health of Little Rock is "just not testosterone therapy," said E.Scot Davis, the CEO of Arkansas Urology. Epoch Health is a subsidiary of Arkansas Urology.

If men complain about gaining weight, being tired or having a low sex drive, they will be given a free screening to determine what's going on, he said.

"It may not necessarily be low testosterone," he said. "If they're truly low-T, we'll treat them. If they aren't, then we're going to get them to an appropriate doctor that they need to see. That's what really makes us different."

Epoch has opened four locations in Arkansas since December 2013. Davis said more clinics in the state are under discussion, but he declined to say where they might be located. There are also Epoch locations in Missouri, Arizona and Alaska. Epoch partners with urologist in those states, and it retains 5-10 percent ownership in the clinics.

Meanwhile, the increased use of testosterone treatments is raising alarm bells for some doctors.

"The idea that large numbers of men should be treated with testosterone is not supported by the science. It's very risky," said Dr. Steven Nissen, the chairman of the department of cardiovascular medicine at the Cleveland Clinic in Ohio. "These kinds of entrepreneurial operations, frankly, are not in the best interest of patients."

Nissen wasn't talking specifically about Epoch.

Testosterone therapy is approved to treat a "very rare condition" of men who don't make testosterone, he said, but "it's now being used as sort of a general tonic for men."

"This is American medicine at its worst," Nissen said.

He also said there are concerns about the cardiovascular safety of the testosterone treatments.

"There are no definitive safety studies," Nissen said. "The studies that we do have are pointing in the wrong direction, suggesting an increase of heart attack and stroke."

In March, the U.S. Food & Drug Administration cautioned that prescription testosterone products are approved only for men who have low testosterone levels caused by certain medical conditions "due to disorders of the testicles, pituitary gland, or brain that cause a condition called hypogonadism," the FDA said on its website. "However, FDA has become aware that testosterone is being used extensively in attempts to relieve symptoms in men who have low testosterone for no apparent reason other than aging."

Davis agreed that a number of men who are being treated for low-T shouldn't be. But at Epoch, he said, patients there are screened and "probably half" don't get the testosterone.

He also said that there are a number of studies to show that testosterone treatment is not risky.

Davis said Epoch conducts proper testing and monitoring of its patients. The clinics that are receiving the bad reputations are the ones that don't, he said.

Dr. Adam Cole, the national medical director for Epoch, says in a video posted on the Epoch website that he looks at testosterone as "not a treatment but more of a tool that a patient can use in order to help turn their life around."

He also boasted about the benefits of testosterone treatments, including sleeping better and a reduction in body fat. "As we progress through this," Cole says in the video, "they'll lose 10-12 percent body fat. They'll gain 10-15 percent more muscle mass."

Epoch's Davis declined to say what the cost for treatment is, but Epoch's website says a patient without insurance can prepay $220 for a month of service.

Nissen said that testosterone clinics "are for-profit operations designed to lure men in and charge them and keep them in the system."

He said once the men come in for the treatments, they have to keep coming back for more treatments.

That's not Epoch's goal, Cole said: "Hopefully, you don't have to be on this therapy for the rest of your life."

Cole said in an interview with Arkansas Business that the goal of Epoch is to get men healthy and do it as safely as possible.

"If we just wanted to make money, we would do the shot box," he said. "Our motto really has been from the beginning, you do what's right for the patient and everything else will take care of itself."

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Title Annotation:Health Care
Author:Friedman, Mark
Publication:Arkansas Business
Geographic Code:1U7AR
Date:May 18, 2015
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